Executive functioning has grown in recent years as a hot topic among therapists and educators. It can be understood from a few different perspectives.
Let's begin with where executive functioning develops in the brain.
Our executive functioning comes from the prefrontal cortex also known as the frontal lobe. This area of the brain is not fully developed until age 45 but does start developing much younger than many suspect. Children begin developing executive functioning as young as 18 months. When a child first learns how to sequence a task, cause and effect and problem solving they are building the initial build blocks for executive functioning skills.
What skills are included in executive functioning?
Initiation for tasks and motivation
Common signs that your child is struggling with executive functioning:
Often losing or forgetting important items
Seeming unable to keep their room, desk or locker clean
Time management issues:
Often being late due to disorganization or poor planning
Trouble moving from one activity to the next
Challenges in school with:
Keeping track of important information
Organizing ideas in writing
Solving multi-step problems
Finishing and turning in homework
Let’s break down a few of these skills and their components:
Organizational Skills: This is the ability to organize and complete a task.
- Working memory: This is a skill worked on a lot in Occupational Therapy; working with a client to build the memory behind a task. For example, most ADL’s are working memory; the task has been done so many times in the same order and way that you have a visualization of the task and its sequence in their head.
- Attention to task: In order for a child to organize a task they must maintain their focus throughout the task. Occupational Therapists work to help children understand ways to better attend to tasks and how to understand what distracts and over/under stimulates their bodies.
- Planning: It takes time and dedication to be organized. Helping children to prioritize the order of tasks and how much time to dedicate to specific tasks is important. This is something that requires a lot of practice and diligence with our clients.
- Time Management: It is often overwhelming for children to organize a task because they have such a difficult time with time. The ability to know how long a task will take to complete, how much time to give to certain tasks and the overall concept of time.
Social Flexibility: This is the ability to have reciprocal conversations and follow peers ideas as well as add in their own ideas and plans.
- Social Reciprocity: This is the ability to understand someone else’s perspective and relate to different people in different settings.
- Coping Skills: It is hard to predict peers and understand everyone's point of view. Helping to build a client's toolbox of coping skills so they can handle adversity and unexpected situations is crucial to social flexibility.
Initiation of Task - Where and how to begin a new or novel task.
- Confidence: The years that executive functioning delays become very apparent are teen years. This is usually when clients are working to come into their own people. Many times it is hard for our clients to initiate tasks because they lack confidence to do so; this could be due to lack of practice, previous failures, intimidation from peers, and/or personal beliefs about themselves.
- Sequencing: Helping children to understand where to begin and how to master a task leads to increased initiation and confidence with tasks.
Problem Solving : This is how you apply your knowledge, previous experiences, and objective thinking to deal with a struggle or problem.
- Size of problem: It is often difficult for children with executive functioning to label the size of their problems and have an appropriate reaction. Helping children to use their skills and knowledge to have a reaction that does not make the problem bigger takes a lot of practice, maturity and control.
- Decision Making: Many times our children who have difficulty with executive functioning are often very indecisive. They lack the ability to make a plan when given a problem and follow through with it by making the first decision.
Impulse control: This is the ability to not act on each thought or emotion that enters your mind.
- Impulse control impacts a child's ability to take turns in a conversation, sharing preferred items, completing less preferred tasks before preferred tasks, resisting peer pressure and/or unhealthy decisions, and/or not giving up on challenging tasks.
- It is often very hard for children who struggle with impulse control to refrain from arguing. They often want to keep negotiating about big and small situations.
- Impulse control plays a major role in social skills. It is hard to make lasting friends when you have difficulty listening to others, being flexible in conversations and working together.
- Emotional regulation is difficult when you don’t have impulse control. Each time a child feels an intense emotion they react in a big way. It is hard for children with executive functioning difficulties to co-regulate with peers and adults.
Ways to work on Executive Functioning Skills:
Structure and Routines: Using visual aids to help with everyday tasks such as grooming, getting ready for school, unloading backpack and bedtime routine. The ability for a child to have routines that are automatic.
Reward Systems: Helping our children with executive functioning deficits know what they are working for can help them stay more focused and complete non-preferred tasks with less negotiating.
Setting Time Limits: Giving specific time amounts for tasks that might take longer than needed and/or preferred tasks so they will transition to the next task.
- Setting a timer can be a great reminder.
Make a checklist: When given new or novel tasks it can be very helpful to allow children to check items off and know the sequence for tasks.
Keep a planner: Helping our older clients to keep track of assignments is very important. This allows parents and teachers to hold children accountable and help them go into their planner to find their assignments.
Giving a specific time in their schedule to just work on organizing and planning their week and assignments. Allowing “study skills” time helps to prioritize getting organized and keeping children on track and from being overwhelmed.
Sensory and/or Brain Breaks: Allow our children with executive functions deficits time to get sensory input such as taking a walk, listening to music, and/or heavy work can help keep them focused and motivated.
Reducing Distractions: Helping children to know how they study best for example, with music, white noise, TV or nothing going on around them. Learning what distracts them helps them to find ways and places that allow for more sustained attention with tasks.
Check Ins: Making such to ask similar questions each day to check in with your child. They can predict and understand what is expected of them when they know what will be asked of them. For example, Can I see your planner, Can you show me your finished checklist and assignments for today?
Concrete Expectations and Consequences: This is the classic “if this; then this”. With our children when they know “If I don’t get my checklist done then I don’t get any TV time at night”. It has to be consistent therefore, they don’t know the expectations and what will happen if they mismanage their time.